Mao Xia, Li Yi, Liu Songya, He Cheng, Yi Shujuan, Kuang Dong, Xiao Min, Zhu Li, Wang Chunyan
Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Hematology, Renmin Hospital of Wuhan University, Wuhan, China.
Front Oncol. 2023 Feb 17;13:1108837. doi: 10.3389/fonc.2023.1108837. eCollection 2023.
There is no unified standard data about the sensitivity and specificity regarding flow cytometry analysis of Ki67 expression during lymphoma diagnoses.
This evaluated the efficacy of multicolor flow cytometry (MFC) in an estimate of the proliferative activity of B-cell non-Hodgkin lymphoma by comparing the expression of Ki67 using MFC and immunohistochemicals (IHC).
A total of 559 patients with non-Hodgkin B-cell lymphoma were immunophenotyped using sensitive MFC, of which 517 were newly diagnosed and 42 were transformed lymphomas. Test samples include peripheral blood, bone marrow, various body fluids, and tissues. Through MFC multi-marker accurate gating, abnormal mature B lymphocytes with restricted expression of the light chain were screened. Ki67 was added to determine the proliferation index; the positive rate of Ki67 in tumor B cells was evaluated by cell grouping and internal control. For tissue specimens, MFC and IHC analyses were performed simultaneously to assess the Ki67 proliferation index.
The positive rate of Ki67 by MFC was correlated with the subtype and aggressiveness of B-cell lymphoma. Ki67 could distinguish indolent lymphomas from aggressive subtypes with a cut-off value of 21.25%, and differentiate transformation from indolent lymphoma with a cut-off value of 7.65%. The expression of Ki67 by MFC (regardless of the type of samples)was highly agreement with the Ki67 proliferative index of tissue samples assessed by pathologic immunohistochemistry. MFC showed a fairly constant negative bias in evaluating tissue or bone marrow samples, compared with IHC.
Ki67 is a valuable flow marker that can distinguish between indolent and aggressive types of lymphoma and assess whether indolent lymphomas are transformed. Using MFC to evaluate the positive rate of Ki67 is important in clinical settings. MFC has unique advantages in judging the aggressiveness of lymphoma in samples of bone marrow, peripheral blood, pleural and ascites, and cerebrospinal fluid. This is particularly important when tissue samples cannot be obtained, making it an important supplement for pathologic examination.
在淋巴瘤诊断过程中，关于Ki67表达的流式细胞术分析的敏感性和特异性，尚无统一的标准数据。
通过比较多色流式细胞术（MFC）和免疫组织化学（IHC）检测的Ki67表达情况，评估MFC在估计B细胞非霍奇金淋巴瘤增殖活性方面的效果。
共纳入559例非霍奇金B细胞淋巴瘤患者，采用灵敏的MFC进行免疫表型分析，其中517例为新诊断患者，42例为转化型淋巴瘤患者。检测样本包括外周血、骨髓、各种体液及组织。通过MFC多标记精确设门，筛选出轻链表达受限的异常成熟B淋巴细胞。加入Ki67测定增殖指数；通过细胞分组和内对照评估肿瘤B细胞中Ki67的阳性率。对于组织标本，同时进行MFC和IHC分析以评估Ki67增殖指数。
MFC检测的Ki67阳性率与B细胞淋巴瘤的亚型及侵袭性相关。Ki67可将惰性淋巴瘤与侵袭性亚型区分开来，临界值为21.25%，并可将转化型淋巴瘤与惰性淋巴瘤区分开来，临界值为7.65%。MFC检测的Ki67表达（无论样本类型如何）与病理免疫组织化学评估的组织样本Ki67增殖指数高度一致。与IHC相比，MFC在评估组织或骨髓样本时显示出相当恒定的负偏差。
Ki67是一种有价值的流式标记物，可区分惰性和侵袭性淋巴瘤类型，并评估惰性淋巴瘤是否发生转化。在临床环境中，使用MFC评估Ki67阳性率很重要。MFC在判断骨髓、外周血、胸水和腹水及脑脊液样本中淋巴瘤的侵袭性方面具有独特优势。当无法获取组织样本时，这一点尤为重要，使其成为病理检查的重要补充。
